1
|
Dev R, Agosta M, Fellman B, Reddy A, Baldwin S, Arthur J, Haider A, Carmack C, Hui D, Bruera E. Coping Strategies and Associated Symptom Burden Among Patients With Advanced Cancer. Oncologist 2024; 29:166-175. [PMID: 37669020 PMCID: PMC10836315 DOI: 10.1093/oncolo/oyad253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/09/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Few studies examine how patients with advanced cancer cope with stress. The objective of our study was to evaluate coping strategies adopted by patients with cancer and their relationship with symptom burden. METHODS A secondary data analysis of a prospective cross-sectional survey of patients with cancer and tobacco use was conducted, which examined demographics, symptom burden (Edmonton Symptom Assessment System), and coping strategies (the Brief COPE Questionnaire). Demographic characteristics were summarized by standard summary statistics; we also examined associations between patient characteristics and coping strategies using t-test, rank-sum test, chi-squared test, or Fisher's exact test depending on the distribution of data. RESULTS Among 399 patients, the majority were female (60%), Caucasian (70%), the mean age was 56.5 (±12.0) years, and the most common malignancies were gastrointestinal (21%) and breast (19%). Patients with cancer adopted multiple adaptive coping strategies, most frequently acceptance (86.7%) and emotional support (79.9%), with humor (18.5%) being the least. Common maladaptive strategies included venting (14.5%) and self-distraction (36.6%), while substance use (1.0%) was infrequently reported. Of the adaptive strategies, female gender was significantly associated with higher engagement with emotional and instrumental support, positive reframing, religious coping, and acceptance (P < .05 for all). College educated patients reported significantly higher implementation of humor, planning, and acceptance. Maladaptive coping strategies such as denial were associated with increased pain and depression, while patients adopting emotional-focused strategies rated decreased emotional distress. CONCLUSIONS The majority of patients with advanced cancer reported adopting multiple, adaptive coping strategies, and a minority utilized maladaptive or avoidant strategies, rarely substance use, and may need additional psychological support.
Collapse
Affiliation(s)
- Rony Dev
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monica Agosta
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bryan Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Akhila Reddy
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarah Baldwin
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph Arthur
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ali Haider
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cindy Carmack
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Hui
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
2
|
Ke Y, Cheung YB, Bakitas M, Odom JN, Lum E, Tan DSW, Tan TJ, Finkelstein E, Oh HC, Zhou S, Yang GM. ENABLE-SG (Educate, Nurture, Advise, Before Life Ends for Singapore) as a proactive palliative care model: protocol for a hybrid type 1 effectiveness-implementation randomized wait-list controlled trial. BMC Palliat Care 2024; 23:29. [PMID: 38287335 PMCID: PMC10826230 DOI: 10.1186/s12904-024-01353-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/16/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Specialist palliative care is often provided late in the patient's disease trajectory in response to uncontrolled symptoms. Shifting from this reactionary illness-stress paradigm to a proactive health-wellness approach, the ENABLE (Educate, Nurture, Advise, Before Life Ends) telehealth model aims to enhance the coping, stress and symptom management, self-care, and advance care planning skills of patients with advanced cancers and their caregivers. The ENABLE model has been culturally adapted to Singapore (ENABLE-SG) and pilot-tested. A hybrid type 1 effectiveness-implementation design will be used to evaluate the effectiveness of ENABLE-SG while collecting real-world implementation data. METHODS This single-centre, assessor-blind, wait-list (immediately vs. 6 months) randomized controlled trial will recruit 300 adult patients within 60 days of an advanced cancer diagnosis and their family caregivers from the National Cancer Centre of Singapore. ENABLE-SG comprises structured psychoeducational sessions with a telehealth coach, covering essential topics of early palliative care. Participants will be assessed at baseline and every 3 months until patient's death, 12 months (caregivers), or end of study (patients). The primary outcome is patient quality of life 6 months after baseline. Secondary patient-reported outcomes include mood, coping, palliative care concerns, and health status. Secondary caregiver-reported outcomes include caregiver quality of life, mood, coping, and care satisfaction. Mixed-effects regression modelling for repeated measurements will be used. To assess the effectiveness of ENABLE-SG versus usual care, patient and caregiver outcomes at 6 months will be compared. To compare earlier versus delayed ENABLE-SG, patient and caregiver outcomes at 12 months will be compared. Within the hybrid type 1 effectiveness-implementation design, implementation outcomes will be evaluated in both the early and delayed groups. Acceptability, adoption, appropriateness, and feasibility will be assessed using a feedback survey and semi-structured interviews with a purposive sample of patients, caregivers, and healthcare providers. Transcribed interviews will be analysed thematically. Other implementation outcomes of penetration, fidelity, and cost will be assessed using records of study-related processes and summarized using descriptive statistics. A cost-effectiveness analysis will also be conducted. DISCUSSION This study will assess both effectiveness and implementation of ENABLE-SG. Insights into implementation processes can facilitate model expansion and upscaling. TRIAL REGISTRATION Registered prospectively on ClinicalTrials.gov, NCT06044441. Registered on 21/09/2023.
Collapse
Affiliation(s)
- Yu Ke
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yin Bun Cheung
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
- Duke-NUS Medical School, Program in Health Services & Systems Research, Singapore, Singapore
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, UAB Centre for Palliative and Supportive Care, Birmingham, AL, USA
| | - J Nicholas Odom
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, UAB Centre for Palliative and Supportive Care, Birmingham, AL, USA
| | - Elaine Lum
- Duke-NUS Medical School, Program in Health Services & Systems Research, Singapore, Singapore
- School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Population Health Research & Implementation, SingHealth, Singapore, Singapore
| | - Daniel Shao Weng Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, Singapore, Singapore
- Genome Institute of Singapore, A*Star, Singapore, Singapore
| | - Tira J Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Oncology Academic Clinical Program, Singapore, Singapore
| | - Eric Finkelstein
- Duke-NUS Medical School, Program in Health Services & Systems Research, Singapore, Singapore
- Duke-NUS Medical School, Lien Centre for Palliative Care, Singapore, Singapore
| | - Hong Choon Oh
- Duke-NUS Medical School, Program in Health Services & Systems Research, Singapore, Singapore
- Centre for Population Health Research & Implementation, SingHealth, Singapore, Singapore
- Health Services Research, Changi General Hospital, Singapore, Singapore
| | - Siqin Zhou
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore, Singapore
| | - Grace Meijuan Yang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Duke-NUS Medical School, Lien Centre for Palliative Care, Singapore, Singapore.
| |
Collapse
|
3
|
DiSipio T, Pearse E, Jordan S. Survivorship research in advanced gynecological cancer: A scoping review of cohort studies. Cancer Med 2023; 12:21779-21797. [PMID: 38009995 PMCID: PMC10757120 DOI: 10.1002/cam4.6744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Recent calls to action highlight the need to address gaps in our understanding of survivorship for those living with advanced gynecological cancer to support optimal care. To ensure future research fills these knowledge gaps, we need to understand the breadth of existing survivorship research in this patient group, including the outcomes assessed, the populations included and the duration and retention in follow-up. METHODS We conducted a systematic scoping review searching PubMed, PsychINFO, and CINAHL during the month of November 2022 to identify prospective cohort studies measuring survivorship outcomes among participants with advanced (stage III-IV) gynecological cancer, or in cohorts in which ≥50% of participants had advanced cancer, or which provide results separately for patients with advanced cancer. Articles were screened, and data extracted using a standard form. RESULTS We assessed 33 articles from 21 unique studies, which overall included 6023 participants with gynecological cancer. Of these, 45% had cervical cancer, 44% ovarian, 10% endometrial/uterine, and 1% vaginal/vulvar cancer. The most frequently measured survivorship outcome was quality of life. Of the 33 articles, most reported on participant age (n = 31), but relatively few reported on comorbidities (n = 10), physical status (n = 6), ethnic background (n = 4), the country of birth (n = 2), or the area of participant residence (n = 2). None included details on indigenous status. Recruitment proportions ranged from 48% to 100%. Retention proportions ranged from 15% to 97%. CONCLUSION Our findings highlight gaps in survivorship research for advanced gynecological cancers and emphasize the need for future studies to include and describe the experiences of diverse and underrepresented groups.
Collapse
Affiliation(s)
- Tracey DiSipio
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Emma Pearse
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Susan Jordan
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| |
Collapse
|
4
|
Hammer MJ, Cooper BA, Chen LM, Wright AA, Pozzar R, Blank SV, Cohen B, Dunn L, Paul S, Conley YP, Levine JD, Miaskowski C. Identification of distinct symptom profiles in patients with gynecologic cancers using a pre-specified symptom cluster. Support Care Cancer 2023; 31:485. [PMID: 37480403 DOI: 10.1007/s00520-023-07954-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/17/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Pain, fatigue, sleep disturbance, and depression are four of the most common symptoms in patients with gynecologic cancer. The purposes were to identify subgroups of patients with distinct co-occurring pain, fatigue, sleep disturbance, and depression profiles (i.e., pre-specified symptom cluster) in a sample of patients with gynecologic cancer receiving chemotherapy and assess for differences in demographic and clinical characteristics, as well as the severity of other common symptoms and QOL outcomes among these subgroups. METHODS Patients completed symptom questionnaires prior to their second or third cycle of chemotherapy. Latent profile analysis was used to identify subgroups of patients using the pre-specified symptom cluster. Parametric and nonparametric tests were used to evaluate for differences between the subgroups. RESULTS In the sample of 233 patients, two distinct latent classes were identified (i.e., low (64.8%) and high (35.2%)) indicating lower and higher levels of symptom burden. Patients in high class were younger, had child care responsibilities, were unemployed, and had a lower annual income. In addition, these women had a higher body mass index, a higher comorbidity burden, and a lower functional status. Patients in the high class reported higher levels of anxiety, as well as lower levels of energy and cognitive function and poorer quality of life scores. CONCLUSIONS This study identified a number of modifiable and non-modifiable risk factors associated with membership in the high class. Clinicians can use this information to refer patients to dieticians and physical therapists for tailored interventions.
Collapse
Affiliation(s)
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Lee-May Chen
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Laura Dunn
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Steven Paul
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA.
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
5
|
Lee J, Shafiq M, Malhotra R, Ozdemir S, Teo I, Malhotra C. Trajectories of Health-related quality of life in patients with Advanced Cancer during the Last Year of Life: findings from the COMPASS study. Palliat Care 2022; 21:183. [PMID: 36242033 PMCID: PMC9569120 DOI: 10.1186/s12904-022-01075-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 08/31/2022] [Accepted: 09/26/2022] [Indexed: 12/01/2022] Open
Abstract
Background Patients with advanced cancer prioritise health-related quality of life (HrQoL) in end-of-life care, however an understanding of pre-death HrQoL trajectories is lacking. We aimed to delineate and describe the trajectories of physical, social, emotional and functional HrQoL during last year of life among advanced cancer patients. We assessed associations between these trajectories and patient socio-demographic characteristics, healthcare use and place of death. Methods We used data from 345 decedents from a prospective cohort study of 600 patients with a solid advanced cancer receiving secondary care at public hospitals in Singapore. Patients were surveyed every three months until death and HrQoL was assessed using the Functional Assessment of Cancer Therapy – General (FACT-G) questionnaire. Interviews were conducted between July 2016 and December 2019. Group-based multi-trajectory modelling was used to assess potential heterogeneity in the four HrQoL dimensions during patients’ last year of life. Results We identified four distinct trajectories of HrQoL − (1) overall high HrQoL (47% of sample), (2) progressively decreasing HrQoL (32%), (3) asymmetric decline in HrQoL (13%), (4) overall low HrQoL (8%). Compared to patients with secondary or above education, those with primary education or less (β = 1.39, SE = 0.55, p-value = 0.012) were more likely to have “progressively decreasing HrQoL” or “overall low HrQoL” in contrast to “overall high HrQoL”. Compared to patients with ‘overall high HrQoL’, those with ‘overall low HrQoL’ had longer length of hospital stay during the last year of life (β = 0.47, SE = 0.21, p-value = 0.026) and were more likely to die in a hospice/care home (β = 1.86, SE = 0.66, p-value = 0.005). Conclusion Our results showed heterogeneity in deterioration of HrQoL among patients with advanced cancer in the last year of life. Systematic monitoring of HrQoL, early identification and referral of high-risk patients to palliative care may provide timely relief and mitigate the steep decline in their HrQoL. Trial Registration : NCT02850640. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01075-3.
Collapse
Affiliation(s)
- Jonathan Lee
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Mahham Shafiq
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Rahul Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore. .,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
| |
Collapse
|
6
|
Marton G, Monzani D, Vergani L, Pizzoli SFM, Pravettoni G. “Optimism Is a Strategy for Making a Better Future”. EUROPEAN PSYCHOLOGIST 2020. [DOI: 10.1027/1016-9040/a000422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Cancer is a deadly disease that can lead to psychological suffering and decreased quality of life (QoL). Personality has been proven to have an effect on QoL and, in particular, Dispositional Optimism (DO) has been studied in relation to overcoming health crisis. The aim of this systematic review is to deepen the state of art of the relationship between QoL and DO in cancer patients. PubMed and Embase databases were systematically searched. Fifteen studies were included with a total of 5,249 cancer patients. All of the studies consider the relationship between DO and QoL, some studies analyze the correlation between the two variables and found a positive association. The majority of the studies investigate the predictive power of DO over QoL and most of them found DO to be predictive of a higher QoL. Results confirmed the association between DO and QoL in a sample of cancer patients. These results could influence the clinical practice as DO has been proven to have a beneficial effect on mental and physical health.
Collapse
Affiliation(s)
- Giulia Marton
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology (IRCCS), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Dario Monzani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology (IRCCS), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Laura Vergani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology (IRCCS), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology (IRCCS), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology (IRCCS), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Italy
| |
Collapse
|
7
|
Lee YK, Praveena KA, Woo YL, Ng CJ. Coping Strategies among Malaysian Women with Recurrent Ovarian Cancer: A Qualitative Study. Asia Pac J Oncol Nurs 2020; 8:40-45. [PMID: 33426188 PMCID: PMC7785070 DOI: 10.4103/apjon.apjon_38_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/27/2020] [Indexed: 11/08/2022] Open
Abstract
Objective: Ovarian cancer is one of the most common cancers among Malaysian women with high recurrence. Patients with recurrence are prone to emotional distress and are forced to cope with poor prognosis. This study aimed to explore the coping strategies employed by women with recurrent ovarian cancer in Malaysia, a developing multicultural country in Asia. Methods: This was a qualitative study with patients diagnosed with recurrent ovarian cancer and receiving chemotherapy at a hospital gynecologic day-care unit. In-depth individual interviews were conducted with patients to explore how they coped with recurrence of ovarian cancer. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Results: The participants' (n = 10) age range was 52–84 years, the three most common ethnic backgrounds were represented (Malay, Chinese, and Indian), and most of the patients were well educated. All patients were on chemotherapy. Six coping strategies were identified: (1) maintaining a mindset of hopefulness, (2) avoidance of information, (3) accepting their condition, (4) seeking spiritual help, (5) relying on family for support, and (6) coping with financial costs. Conclusions: Coping strategies employed during ovarian cancer recurrence in this setting were rarely based on the accurate information appraisal, but rather on the individual emotion and personal beliefs.
Collapse
Affiliation(s)
- Yew Kong Lee
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K Asokan Praveena
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yin Ling Woo
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
8
|
Culha I, Gursoy E, Bulut H. Investigating the Effect of a Structured Discharge Training Program on Patient Outcomes Following Gynecologic Oncology Surgery. Clin Nurs Res 2020; 29:616-626. [PMID: 32456449 DOI: 10.1177/1054773820917299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to investigate the effect of a discharge training program structured according to the Roy adaptation model (RAM) on patient outcomes (quality of life, coping-adaptation, self-esteem) following gynecologic oncology surgery. This nonrandomized intervention studies consisted of two stages. In the first stage, patients were interviewed, patient needs after discharges were determined. Interview data were analyzed, and RAM-based training booklet was prepared. This booklet was prepared in line with a number of themes. In the second stage, the study was conducted with a sample of 36 control and 36 intervention patients, who were included in the discharge training program. Data was collected preoperatively, at 9th and 13th weeks after discharge. The mean quality of life and coping/adaptation scores of the intervention group at 13th weeks were significantly higher than those of the control group, however, no significant difference was found between the groups in terms of mean self-esteem scores.
Collapse
Affiliation(s)
- Ilkay Culha
- Nursing Department, Faculty of Health Science, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Elif Gursoy
- Nursing Department, Faculty of Health Science, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Hulya Bulut
- Nursing Department, Faculty of Health Science, Gazi University, Ankara, Turkey
| |
Collapse
|
9
|
Mothering With Advanced Ovarian Cancer: "You've Got to Find That Little Thing That's Going to Make You Strong". Cancer Nurs 2020; 42:E54-E60. [PMID: 29489476 DOI: 10.1097/ncc.0000000000000550] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mothers with ovarian cancer are at risk of experiencing additional demands given their substantial symptom burden and accelerated disease progression. OBJECTIVE This study describes the experience of mothers with ovarian cancer, elucidating the interaction between their roles as mothers and patients with cancer. METHODS We conducted a secondary analysis of focus groups with women with advanced ovarian cancer. Using descriptive coding, we developed a coding framework based on emerging findings and group consensus. We then identified higher-order themes capturing the breadth of experiences described by mothers with ovarian cancer. RESULTS Eight of the 13 participants discussed motherhood. The mean age of participants was 48.38 (SD, 7.17) years. All women were white (9/9), most had some college education (6/9), and the majority were married (5/9). Mean time since diagnosis was 7.43 (SD, 4.69) months; more than half of women (5/9) were currently receiving treatment. Themes and exemplar quotes reflected participants' evolving self-identities from healthy mother to cancer patient to woman mothering with cancer. Subthemes related to how motherhood was impacted by symptoms, demands of treatment, and the need to gain acceptance of living with cancer. CONCLUSIONS The experience of motherhood impacts how women experience cancer and how they evolve as survivors. Similarly, cancer influences mothering. IMPLICATIONS FOR PRACTICE Healthcare providers should understand and address the needs of mothers with ovarian cancer. This study adds to the limited literature in this area and offers insight into the unique needs faced by women mothering while facing advanced cancer.
Collapse
|
10
|
Mariani A, Wang C, Oberg AL, Riska SM, Torres M, Kumka J, Multinu F, Sagar G, Roy D, Jung DB, Zhang Q, Grassi T, Visscher DW, Patel VP, Jin L, Staub JK, Cliby WA, Weroha SJ, Kalli KR, Hartmann LC, Kaufmann SH, Goode EL, Shridhar V. Genes associated with bowel metastases in ovarian cancer. Gynecol Oncol 2019; 154:495-504. [PMID: 31204077 DOI: 10.1016/j.ygyno.2019.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study is designed to identify genes and pathways that could promote metastasis to the bowel in high-grade serous ovarian cancer (OC) and evaluate their associations with clinical outcomes. METHODS We performed RNA sequencing of OC primary tumors (PTs) and their corresponding bowel metastases (n = 21 discovery set; n = 18 replication set). Differentially expressed genes (DEGs) were those expressed at least 2-fold higher in bowel metastases (BMets) than PTs in at least 30% of patients (P < .05) with no increased expression in paired benign bowel tissue and were validated with quantitative reverse transcription PCR. Using an independent OC cohort (n = 333), associations between DEGs in PTs and surgical and clinical outcomes were performed. Immunohistochemistry and mouse xenograft studies were performed to confirm the role of LRRC15 in promoting metastasis. RESULTS Among 27 DEGs in the discovery set, 21 were confirmed in the replication set: SFRP2, Col11A1, LRRC15, ADAM12, ADAMTS12, MFAP5, LUM, PLPP4, FAP, POSTN, GRP, MMP11, MMP13, C1QTNF3, EPYC, DIO2, KCNA1, NETO1, NTM, MYH13, and PVALB. Higher expression of more than half of the genes in the PT was associated with an increased requirement for bowel resection at primary surgery and an inability to achieve complete cytoreduction. Increased expression of LRRC15 in BMets was confirmed by immunohistochemistry and knockdown of LRRC15 significantly inhibited tumor progression in mice. CONCLUSIONS We identified 21 genes that are overexpressed in bowel metastases among patients with OC. Our findings will help select potential molecular targets for the prevention and treatment of malignant bowel obstruction in OC.
Collapse
Affiliation(s)
- Andrea Mariani
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Chen Wang
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Ann L Oberg
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Shaun M Riska
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Michelle Torres
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Joseph Kumka
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Francesco Multinu
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Gunisha Sagar
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Debarshi Roy
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Deok-Beom Jung
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Qing Zhang
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Tommaso Grassi
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Daniel W Visscher
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Vatsal P Patel
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Ling Jin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Julie K Staub
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - William A Cliby
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Saravut J Weroha
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Kimberly R Kalli
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Lynn C Hartmann
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Scott H Kaufmann
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Viji Shridhar
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| |
Collapse
|
11
|
Mindfulness-based interventions for cancer-related pain and depression: a narrative review of current evidence and future potential. Curr Opin Support Palliat Care 2019; 13:81-87. [DOI: 10.1097/spc.0000000000000428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Stanton AL, Wiley JF, Krull JL, Crespi CM, Weihs KL. Cancer-related coping processes as predictors of depressive symptoms, trajectories, and episodes. J Consult Clin Psychol 2018; 86:820-830. [PMID: 30265041 DOI: 10.1037/ccp0000328] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Although numerous studies address the relationships of depression with coping processes directed toward approaching or avoiding stressful experiences, the large majority are cross-sectional in design, assess coping processes at only one timepoint, or solely include prediction of the linear slope of depressive symptoms. In this research, coping processes were investigated as predictors of depressive symptoms, symptom trajectory classes (consistently high, recovery, consistently low), and major depressive episodes (MDEs) over 12 months in the cancer context. METHOD Women (N = 460) within 4 months of breast cancer diagnosis completed assessments of cancer-related coping processes, depressive symptoms, and MDEs at 7 points across 1 year. RESULTS Beyond sociodemographic and medical variables, coping through cancer-related avoidance an average of 2 months after diagnosis was associated with likelihood of being in the high depressive symptom trajectory class and occurrence of a MDE during the year. Less decline in avoidant coping over time also predicted poor outcomes. In contrast, high initial engagement in approach-oriented coping, as well as increases in coping through emotional expression and acceptance, were associated with lower depressive symptoms across assessments and higher likelihood of being in the recovery or low trajectory class. CONCLUSIONS Greater engagement in cancer-related avoidant coping was associated with all three indicators of depression, and greater approach-oriented coping was related to more favorable outcomes (except MDE). Sustained or increasing coping through emotional expression or acceptance predicted recovery from initially high depressive symptoms. Approach- and avoidance-oriented coping processes constitute malleable targets for preventive and ameliorative approaches. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | | | - Catherine M Crespi
- Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | | |
Collapse
|
13
|
Miller D, Nevadunsky N. Palliative Care and Symptom Management for Women with Advanced Ovarian Cancer. Hematol Oncol Clin North Am 2018; 32:1087-1102. [DOI: 10.1016/j.hoc.2018.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
14
|
Dev R, Kim YJ, Reddy A, Hui D, Tanco K, Liu D, Park M, Williams J, Carmack C, Bruera E. Association between tobacco use, pain expression, and coping strategies among patients with advanced cancer. Cancer 2018; 125:153-160. [PMID: 30351502 DOI: 10.1002/cncr.31783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/06/2018] [Accepted: 08/29/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND The objective of the current study was to evaluate the association between tobacco use, symptom expression, and coping strategies in patients with advanced cancer. METHODS The authors prospectively enrolled patients with advanced cancer and collected data regarding patient demographics, cancer diagnosis, morphine equivalent daily dose, cigarette smoking status using the Behavioral Risk Factor Surveillance System, symptom expression as measured by the Edmonton Symptom Assessment System, the Cut down/Annoyed/Guilty/Eye opener alcoholism questionnaire, the Screener and Opioid Assessment for Patients with Pain-short form survey, and the Brief COPE Questionnaire. RESULTS Among 399 patients, 195 (49%) were never-smokers, 158 (40%) were former smokers, and 46 (11%) were current smokers. The most common malignancies were gastrointestinal (21%) and breast (19%). Current smokers demonstrated significantly higher pain scores at the time of consultation compared with former or never-smokers (mean 6.4 vs 5.9 vs 5.1, respectively; P = .015), demonstrated increased morphine equivalent daily dose (median 90 mg/day vs 60 mg/day vs 50 mg/day, respectively; P = .002), were more likely to screen as positive on the Cut down/Annoyed/Guilty/Eye opener questionnaire (33% vs 24% vs 8.7%, respectively; P < .0001) and were more likely to screen as positive (≥4) on the Screener and Opioid Assessment for Patients with Pain-short form survey (74% vs 13% vs 9.3%, respectively; P < .0001). Compared with former and never-smokers, current smokers were significantly more likely to cope maladaptively with substance use (P = .02), denial (P = .007), and self-blame (P < .0001). CONCLUSIONS Among patients with advanced cancer, current and former smokers appear to be significantly more likely to have higher pain expression and thus require higher opioid doses, and to have more risk factors for using opioids in a nonprescribed manner. The results of the current study highlight the need to provide closer monitoring and increased psychosocial support for patients with cancer who smoke while receiving chronic opioid therapy.
Collapse
Affiliation(s)
- Rony Dev
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yu Jung Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Akhila Reddy
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Hui
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kimberson Tanco
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diane Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Minjeong Park
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Janet Williams
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Cindy Carmack
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
15
|
Beesley VL, Smith DD, Nagle CM, Friedlander M, Grant P, DeFazio A, Webb PM. Coping strategies, trajectories, and their associations with patient-reported outcomes among women with ovarian cancer. Support Care Cancer 2018; 26:4133-4142. [PMID: 29948398 DOI: 10.1007/s00520-018-4284-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 05/21/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Most women with ovarian cancer present with advanced stage disease and face aggressive treatments, recurrence, and possible death, yet little is known about how they cope. Our objective was to identify coping strategies used by women with ovarian cancer and their trajectories of use after diagnosis and to assess if coping trajectories are associated with subsequent anxiety, depression, or quality of life. METHODS Women with ovarian cancer completed questionnaires including the Brief-COPE, HADS, and FACT at 3, 6, and 9 months after diagnosis and the HADS and FACT at 12 months. Using data from 634 women who completed the 3-month questionnaire, factor analysis was conducted to identify coping strategy clusters. Trajectory modeling was used to assess patterns of coping over time. Associations between coping trajectory from 3 to 9 months and patient-reported outcomes at 12 months were investigated using general linear models. RESULTS Three coping strategy clusters were identified. Use of "taking action/positive framing" followed four distinct trajectories over time: low-stable (44%), medium-stable (32%), medium-decreasing (11%), high-stable (12%). Use of "social/emotional support" had four trajectories: low-increasing (7%), low-decreasing (44%), medium-decreasing (40%), and high-stable (8%). Women either "accepted their reality" (26%) or "used some denial" (74%). Women who accepted reality reported significantly less anxiety and depression and better quality of life at 12 months. Women with high-stable use of taking action/positive framing reported less depression. Women with high-stable use of social/emotional support reported better quality of life. CONCLUSIONS Strategies to assist women with acceptance, action-planning, positive-framing, and maintaining psychosocial support should be considered.
Collapse
Affiliation(s)
- Vanessa L Beesley
- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.
| | - David D Smith
- Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Christina M Nagle
- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia
| | | | - Peter Grant
- Gynaecological Oncology Unit, Mercy Hospital for Women, Melbourne, Australia
| | - Anna DeFazio
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia
| | - Penelope M Webb
- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia
| | | |
Collapse
|
16
|
Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study. Gynecol Oncol 2018; 150:119-126. [PMID: 29778506 DOI: 10.1016/j.ygyno.2018.05.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. METHODS Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months. RESULTS We enrolled 102 evaluable patients. Initiation of Do Not Resuscitate (DNR) discussions increased over time from 28% at study entry to 37% at 6 months. At study entry, the most common disease-related symptoms were fatigue (92%), worry (89%), and trouble sleeping (76%); 73% reported being "bothered by treatment side effects", which included nausea (41%) and hair loss (51%) neither of which changed over time. The most common NEST unmet needs were in the symptom dimension. The social dimension was associated with F/WB (p = 0.002) and FACIT-F (p = 0.006); symptoms were associated with DRS (p = 0.04), TSE (p = 0.03), and FACIT-F (p = 0.04); existential was not associated with any of the patient-reported symptoms; therapeutic was associated with F/WB (p = 0.02). CONCLUSIONS In patients nearing the end of life, there are significant associations between disease and treatment related symptoms and unmet patient needs, which do not change substantially over time. Careful exploration of specific end-of-life care needs can improve patient-centered care and QOL.
Collapse
|
17
|
Abstract
OBJECTIVE Ovarian cancer recurs in most patients, with a 5-year survival rate less than 30%. Quality of life is an increasingly important issue in patients with cancer, but there are limited data in women with recurrent ovarian cancer in this regard. MATERIALS AND METHODS We used an ad hoc questionnaire to compare changes in health perceptions, burden of disease, and expectations for the future quality of life in women with and without recurrence of ovarian cancer. A total of 173 women were included, 116 with relapse and 57 without, undergoing follow-up in a routine clinical setting. RESULTS Substantial differences were seen in self-assessed health status between women with and without recurrence; 33.6% and 82.4% of women with and without recurrence rated their health as good to excellent, respectively. More patients with recurrence of disease reported limitations in moderate activity than those without. Furthermore, 79.0% of women without recurrence reported that pain did not affect or only slightly affected daily activities, compared with 28.2% with recurrence. Most women with recurrence (59.5%) reported that they were able to do less than they wanted to because of their emotional status compared with only 15.8% of women without recurrence. In addition, 66.4% of women with recurrence referred that they had problems concentrating at work and home versus 26.3% of women without recurrence. CONCLUSIONS From this survey, it is clear that relapse of disease has a negative psychological and physical impact, highlighting the importance of time without recurrence and the need for effective treatment in the long term.
Collapse
|
18
|
Frazer MS, Mobley P. A mixed methods analysis of quality of life among late-life patients diagnosed with chronic illnesses. Health Qual Life Outcomes 2017; 15:222. [PMID: 29145869 PMCID: PMC5691830 DOI: 10.1186/s12955-017-0797-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/07/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Quality of life (QOL) is an important consideration for people living with advancing chronic conditions. Palliative care providers speak about how, despite physical decline in late life, many patients report growth and meaning in other domains. This mixed methods study uses QOL survey responses to explore domain trajectories and interview data to explore how patients with advancing chronic conditions experience distinct QOL domains. METHODS The study sample includes 156 now-deceased participants who completed the FACIT-Pal quarterly, and 40 (10 now-deceased) participants who discussed QOL in an interview. Mean subscale scores were plotted over participants' last 18 months to reveal QOL trajectories. Interview data were analyzed to reveal how participants' experience, actions and cognitive processes influenced QOL scores. RESULTS Physical and functional subscale ratings show gradual decline. Emotional QOL maintains with a small dip 2-3 months before death, and social QOL ratings improve in participants' final 3 months. Participants create and strengthen relationships that help them better manage health and receive instrumental and emotional support; seek activities in which they can find joy, meaning, and purpose; and support cognitions through which patients accept and communicate about illness, and emphasize positives. CONCLUSION QOL domains exist in different trajectories. Despite physical and functional decline, participant ratings of emotional QOL maintain and ratings of social QOL improve at end of life. Understanding the processes through which participants countered declining QOL may help providers identify how to best support and promote improved QOL for patients during their final months.
Collapse
Affiliation(s)
- Monica S. Frazer
- Senior Researcher, Optum Division of Health Economics and Outcomes Research, 11000 Optum Circle, Eden Prairie, MN 55344 USA
| | - Patrick Mobley
- Data Scientist, Sentience Data and Analytics, Honeywell, Inc., 12001 Hwy 55, Plymouth, MN 55441 USA
| |
Collapse
|
19
|
Sharif SP, Khanekharab J. External locus of control and quality of life among Malaysian breast cancer patients: The mediating role of coping strategies. J Psychosoc Oncol 2017; 35:706-725. [DOI: 10.1080/07347332.2017.1308984] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Saeed Pahlevan Sharif
- Taylor's Business School, Taylor's University Lakeside Campus, Subang Jaya, Selangor, Malaysia
| | - Jasmine Khanekharab
- Graduate School of Business, University Tun Abdul Razak, Kuala Lumpur, Malaysia
| |
Collapse
|
20
|
Hill EM, Watkins K. Women with Ovarian Cancer: Examining the Role of Social Support and Rumination in Posttraumatic Growth, Psychological Distress, and Psychological Well-being. J Clin Psychol Med Settings 2017; 24:47-58. [DOI: 10.1007/s10880-016-9482-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
21
|
Mercieca-Bebber RL, Price MA, Bell ML, King MT, Webb PM, Butow PN. Ovarian cancer study dropouts had worse health-related quality of life and psychosocial symptoms at baseline and over time. Asia Pac J Clin Oncol 2016; 13:e381-e388. [PMID: 27573704 DOI: 10.1111/ajco.12580] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 06/08/2016] [Accepted: 06/14/2016] [Indexed: 11/29/2022]
Abstract
AIMS Participant drop out is a major barrier to high-quality patient-reported outcome (PRO) data analysis in cancer research as patients with worsening health are more likely to dropout. To test the hypothesis that ovarian cancer patients with worse PROs would drop out earlier, we examined how patients differed by time of dropout on health-related quality of life (HRQOL), anxiety, depression, optimism and insomnia. METHODS This analysis included 619 participants, stratified by time of dropout, from the Australian Ovarian Cancer Study - Quality of Life substudy, in which participants completed PRO questionnaires at three-monthly intervals for 21 months. Trends in PROs over time were examined. Pearson correlations examined the relationship between time of dropout and baseline PROs. Multiple linear regression models including age, disease stage and time since diagnosis examined relationships between baseline and final PRO scores, and final PRO scores and dropout group. RESULTS Participants who dropped out earlier had significantly worse baseline HRQOL (p < 0.0001) and higher depression (p < 0.0001). For all five PROs, final scores were significantly associated with baseline scores (p < 0.0001). Time of dropout was significantly associated with final HRQOL (p = 0.003), anxiety (p = 0.05), depression (p = 0.02) and optimism (p = 0.02) scores. Depression, HRQOL and anxiety worsened at a faster rate overtime in dropouts than study completers. CONCLUSIONS Poorer HRQOL and higher depression at baseline, and final HRQOL, anxiety, depression and optimism scores were predictive of time of dropout. These results highlight the importance of collecting auxiliary data to inform careful and considered handling of missing PRO data during analysis, interpretation and reporting.
Collapse
Affiliation(s)
- Rebecca L Mercieca-Bebber
- Central Clinical School, Sydney Medical School, University of Sydney, NSW, Australia.,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW, Australia
| | - Melanie A Price
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPeD), School of Psychology, University of Sydney, NSW, Australia
| | - Melanie L Bell
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW, Australia.,Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Madeleine T King
- Central Clinical School, Sydney Medical School, University of Sydney, NSW, Australia.,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW, Australia
| | - Penelope M Webb
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Phyllis N Butow
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPeD), School of Psychology, University of Sydney, NSW, Australia
| | | |
Collapse
|
22
|
van den Beuken-van Everdingen MHJ, Hochstenbach LMJ, Joosten EAJ, Tjan-Heijnen VCG, Janssen DJA. Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis. J Pain Symptom Manage 2016; 51:1070-1090.e9. [PMID: 27112310 DOI: 10.1016/j.jpainsymman.2015.12.340] [Citation(s) in RCA: 939] [Impact Index Per Article: 117.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/10/2015] [Accepted: 12/23/2015] [Indexed: 12/17/2022]
Abstract
CONTEXT Cancer pain has a severe impact on quality of life and is associated with numerous psychosocial responses. Recent studies suggest that treatment of cancer pain has improved during the last decade. OBJECTIVES The aim of this review was to examine the present status of pain prevalence and pain severity in patients with cancer. METHODS A systematic search of the literature published between September 2005 and January 2014 was performed using the databases PubMed, Medline, Embase, CINAHL, and Cochrane. Articles in English or Dutch that reported on the prevalence of cancer pain in an adult population were included. Titles and abstracts were screened by two authors independently, after which full texts were evaluated and assessed on methodological quality. Study details and pain characteristics were extracted from the articles with adequate study quality. Prevalence rates were pooled with meta-analysis; meta-regression was performed to explore determinants of pain prevalence. RESULTS Of 4117 titles, 122 studies were selected for the meta-analyses on pain (117 studies, n = 63,533) and pain severity (52 studies, n = 32,261). Pain prevalence rates were 39.3% after curative treatment; 55.0% during anticancer treatment; and 66.4% in advanced, metastatic, or terminal disease. Moderate to severe pain (numerical rating scale score ≥5) was reported by 38.0% of all patients. CONCLUSION Despite increased attention on assessment and management, pain continues to be a prevalent symptom in patients with cancer. In the upcoming decade, we need to overcome barriers toward effective pain treatment and develop and implement interventions to optimally manage pain in patients with cancer.
Collapse
Affiliation(s)
- Marieke H J van den Beuken-van Everdingen
- Center of Expertise for Palliative Care, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands; Department of Anesthesiology and Pain Management, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.
| | - Laura M J Hochstenbach
- School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands; Department of Health Services Research, Maastricht University (UM), Maastricht, The Netherlands
| | - Elbert A J Joosten
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands; School of Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Vivianne C G Tjan-Heijnen
- School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands; Department of Medical Oncology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Daisy J A Janssen
- Center of Expertise for Palliative Care, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands; Department of Research and Education, Center of Expertise for Chronic Organ Failure, CIRO+, Horn, The Netherlands
| |
Collapse
|
23
|
Tuncay T. Coping and quality of life in Turkish women living with ovarian cancer. Asian Pac J Cancer Prev 2016; 15:4005-12. [PMID: 24935587 DOI: 10.7314/apjcp.2014.15.9.4005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigated the utilization of both problem and emotion focused coping strategies and their association with aspects of quality of life among Turkish women with ovarian cancer undergoing chemotherapy. MATERIALS AND METHODS The convenience sample consisted of 228 patients in all disease stages. The data were collected using the brief COPE, QOL-Cancer patient tool, sociodemographic sheet, and medical variables were gathered from patients' medical charts. RESULTS Findings reveal that quality of life is moderately high for this group of cancer patients, despite some specific negative facets of the illness and treatment experience. Acceptance, emotional support and religion were the most frequently used problem-focused coping strategies and self-distraction, venting and behavioral disengagement were the most frequently used emotion-focused coping strategies reported by patients. Overall quality of life and, particularly, psychological and spiritual well- being scores of younger patients were lower. Patients reported using significantly more problem-focused coping than emotion-focused coping, and more problem-focused and less emotion-focused coping predicted greater quality of life. Problem-focused coping was related to patients' physical and spiritual well-being and emotion- focused coping was related inversely with psychological and social well-being. CONCLUSIONS Coping strategies are influential in patient quality of life and their psychosocial adaptation to ovarian cancer. Psycho-oncology support programs are needed to help patients to frequent use of problem-focused coping and reduce emotion- focused coping strategies to improve overall quality of life.
Collapse
Affiliation(s)
- Tarik Tuncay
- Department of Social Work, FEAS, Hacettepe University, Ankara, Turkey E-mail :
| |
Collapse
|
24
|
Yahaya NA, Subramanian P, Bustam AZ, Taib NA. Symptom experiences and coping strategies among multi- ethnic solid tumor patients undergoing chemotherapy in Malaysia. Asian Pac J Cancer Prev 2015; 16:723-30. [PMID: 25684515 DOI: 10.7314/apjcp.2015.16.2.723] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was performed to assess patient symptoms prevalence, frequency and severity, as well as distress and coping strategies used, and to identify the relationships between coping strategies and psychological and physical symptoms distress and demographic data of cancer patients. This cross-sectional descriptive study involved a total of 268 cancer patients with various types of cancer and chemotherapy identified in the oncology unit of an urban tertiary hospital. MATERIALS AND METHODS Data were collected using questionnaires (demographic questionnaire, Medical characteristics, Memorial Symptom Assessment Scale (MSAS) and Brief COPE scales and analyzed for demographic, and disease-related variable effects on symptom prevalence, severity, distress and coping strategies. RESULTS Symptom prevalence was relatively high and ranged from 14.9% for swelling of arms and legs to 88.1% for lack of energy. This latter was the highest rated symptom in the study. The level of distress was found to be low in three domains. Problem-focused coping strategies were found to be more commonly employed compared to emotion-focused strategies, demonstrating significant associations with sex, age group, educational levels and race. However, there was a positive correlation between emotion-focused strategies and physical and psychological distress, indicating that patients would choose emotion-focused strategies when symptom distress increased. CONCLUSIONS These findings demonstrate that high symptom prevalence rates and coping strategies used render an improvement in current nursing management. Therefore development of symptoms management groups, encouraging the use of self-care diaries and enhancing the quality of psycho- oncology services provided are to be recommended.
Collapse
Affiliation(s)
- Nor Aziyan Yahaya
- Department of Nursing Science, Faculty of Medicine, University Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia E-mail :
| | | | | | | |
Collapse
|
25
|
Hill EM. Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking. PSYCHOL HEALTH MED 2015; 21:551-61. [PMID: 26549407 DOI: 10.1080/13548506.2015.1109674] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.
Collapse
Affiliation(s)
- Erin M Hill
- a Department of Psychology , West Chester University , West Chester , PA , USA
| |
Collapse
|
26
|
Roomaney R, Kagee A. Coping strategies employed by women with endometriosis in a public health-care setting. J Health Psychol 2015; 21:2259-68. [PMID: 25769875 DOI: 10.1177/1359105315573447] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explored how South African patients attending public health facilities reported coping with endometriosis. A total of 16 women with endometriosis were interviewed, and we explored how participants coped with endometriosis. All interviews were audio-recorded and transcribed. Thematic analysis was used to identify themes. Participants reported employing both problem-focused and emotion-focused strategies to cope with endometriosis. Problem-focused strategies included limiting physical activities, increasing knowledge about endometriosis, scheduling social and work activities around menstrual cycle, engaging in self-management and relying on social support. Emotion-focused coping strategies included accepting the disease, adopting a positive attitude, engaging in self talk and evoking spirituality.
Collapse
|
27
|
Chittrakul S, Charoenkwan K, Wongpakaran N. Prevalence of Anxiety May Not be Elevated in Thai Ovarian Cancer Patients Following Treatment. Asian Pac J Cancer Prev 2015; 16:1251-4. [DOI: 10.7314/apjcp.2015.16.3.1251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
28
|
Bryand A, Hamidou Z, Paget-Bailly S, Bonnetain F, Mathelin C, Baldauf JJ, Akladios C. [Health-related quality of life in patients treated for ovarian cancer: tools and issues]. ACTA ACUST UNITED AC 2015; 43:151-7. [PMID: 25596884 DOI: 10.1016/j.gyobfe.2014.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 12/15/2014] [Indexed: 11/30/2022]
Abstract
Health-related quality of life (QoL) in patients treated for ovarian cancer is directly and heavily impacted by the natural history of cancer, its evolution and its therapeutic modalities. The evaluation and consideration of various parameters of QoL seems to be a major issue. Indeed, on the one hand, it is essential to take into account the opinion of patients in the choice of therapeutic strategies for this cancer with a poor prognosis and, on the other hand, more and more studies show that QoL is an independent prognostic factor in ovarian cancer. Improvement in this case, in addition to being an endpoint by itself, would potentially improve the overall survival of patients. To date there are several tools to assess QOL of patients with ovarian cancer. The 2 questionnaires most commonly used are: FACT-O and the EORTC QLQ-OV28. The aim of our study was to evaluate from a review of the literature, the reciprocal effects of ovarian cancer on QoL and QoL on ovarian cancer survival, as well as specificities of each of the 2 questionnaires most commonly used in assessing the QoL.
Collapse
Affiliation(s)
- A Bryand
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - Z Hamidou
- Service de santé publique, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex, France
| | - S Paget-Bailly
- CHRU de Besançon, 2, place Saint-Jacques, 25000 Besançon, France
| | - F Bonnetain
- CHRU de Besançon, 2, place Saint-Jacques, 25000 Besançon, France
| | - C Mathelin
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - J-J Baldauf
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - C Akladios
- CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| |
Collapse
|
29
|
Yu SY, Nho JH. Influence of Sleep Disturbance and Depression on Quality of Life in Ovarian Cancer Patients during Chemotherapy. ASIAN ONCOLOGY NURSING 2015. [DOI: 10.5388/aon.2015.15.4.203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sun-Young Yu
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Ju-Hee Nho
- College of Nursing, Chonnam National University, Gwangju, Korea
| |
Collapse
|
30
|
Targeting those with decreased meaning and peace: a supportive care opportunity. Support Care Cancer 2014; 23:2025-32. [PMID: 25519758 DOI: 10.1007/s00520-014-2568-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate if an individual's level of meaning/peace (M/P) predicts various quality of life (QOL) and mental well-being measures. To identify targets that might enhance the overall spiritual well-being and QOL of ovarian cancer patients. METHODS Multi-site analysis of women with newly diagnosed stages II-IV ovarian, primary peritoneal, or fallopian tube cancer. Patients completed the following surveys: Functional Assessment of Chronic Illness Therapy-Ovarian (FACT-O), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), Templer's Death Anxiety Scale (DAS), Herth Hope Index (HHI), and Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS). Linear regression models were created to examine the effect of M/P (FACIT-Sp) upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of site, race, age, stage, anaphylaxis to chemotherapy, and partner status as potential confounders. RESULTS This study enrolled 104 patients from three separate sites. After adjusting for potential confounders, it was found that higher M/P predicted better QOL (FACT-O) (p < 0.0001). Higher M/P also predicted decreased death anxiety, depression, and anxiety (p ≤ 0.005). Finally, higher M/P predicted increased hope and coping scores (p ≤ 0.0005). CONCLUSIONS Level of M/P is associated with several important mental and physical health states. This information may allow providers to identify patients at increased risk for mental/physical distress and may facilitate early referral to targeted psychotherapy interventions focused on improving patient QOL and decreasing anxiety and depression.
Collapse
|
31
|
Changes in health-related quality of life and quality of care among terminally ill cancer patients and survival prediction: Multicenter prospective cohort study. Palliat Support Care 2014; 13:1103-11. [DOI: 10.1017/s1478951514000960] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:This study examined changes in health-related quality of life (HRQoL) and quality of care (QoC) as perceived by terminally ill cancer patients and a stratified set of HRQoL or QoC factors that are most likely to influence survival at the end of life (EoL).Method:We administered questionnaires to 619 consecutive patients immediately after they were diagnosed with terminal cancer by physicians at 11 university hospitals and at the National Cancer Center in Korea. Subjects were followed up over 161.2 person-years until their deaths. We measured HRQoL using the core 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and QoC using the Quality Care Questionnaire–End of Life (QCQ–EoL). We evaluated changes in HRQoL and QoC issues during the first three months after enrollment, performing sensitivity analysis by using data generated via four methods (complete case analysis, available case analysis, the last observation carried forward, and multiple imputation).Results:Emotional and cognitive functioning decreased significantly over time, while dyspnea, constipation, and pain increased significantly. Dignity-conserving care, care by healthcare professionals, family relationships, and QCQ–EoL total score decreased significantly. Global QoL, appetite loss, and Eastern Cooperative Oncology Group Performance Status (ECOG–PS) scores were significantly associated with survival.Significance of results:Future standardization of palliative care should be focused on assessment of these deteriorated types of quality. Accurate estimates of the length of life remaining for terminally ill cancer patients by such EoL-enhancing factors as global QoL, appetite loss, and ECOG–PS are needed to help patients experience a dignified and comfortable death.
Collapse
|
32
|
Syrjala KL, Jensen MP, Mendoza ME, Yi JC, Fisher HM, Keefe FJ. Psychological and behavioral approaches to cancer pain management. J Clin Oncol 2014; 32:1703-11. [PMID: 24799497 PMCID: PMC4031190 DOI: 10.1200/jco.2013.54.4825] [Citation(s) in RCA: 199] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This review examines evidence for psychological factors that affect pain across the cancer continuum from diagnosis through treatment and long-term survivorship or end of life. Evidence is convincing that emotional distress, depression, anxiety, uncertainty, and hopelessness interact with pain. Unrelieved pain can increase a desire for hastened death. Patients with cancer use many strategies to manage pain, with catastrophizing associated with increased pain and self-efficacy associated with lower pain reports. A variety of psychological and cognitive behavioral treatments can reduce pain severity and interference with function, as indicated in multiple meta-analyses and high-quality randomized controlled trials. Effective methods include education (with coping skills training), hypnosis, cognitive behavioral approaches, and relaxation with imagery. Exercise has been tested extensively in patients with cancer and long-term survivors, but few exercise studies have evaluated pain outcomes. In survivors post-treatment, yoga and hypnosis as well as exercise show promise for controlling pain. Although some of these treatments effectively reduce pain for patients with advanced disease, few have been tested in patients at the end of life. Given the clear indicators that psychological factors affect cancer pain and that psychological and behavioral treatments are effective in reducing varying types of pain for patients with active disease, these methods need further testing in cancer survivors post-treatment and in patients with end-stage disease. Multidisciplinary teams are essential in oncology settings to integrate analgesic care and expertise in psychological and behavioral interventions in standard care for symptom management, including pain.
Collapse
Affiliation(s)
- Karen L Syrjala
- Karen L. Syrjala and Jean C. Yi, Fred Hutchinson Cancer Research Center; Karen L. Syrjala, Mark P. Jensen, and M. Elena Mendoza, University of Washington, Seattle, WA; and Hannah M. Fisher and Francis J. Keefe, Duke University, Durham, NC.
| | - Mark P Jensen
- Karen L. Syrjala and Jean C. Yi, Fred Hutchinson Cancer Research Center; Karen L. Syrjala, Mark P. Jensen, and M. Elena Mendoza, University of Washington, Seattle, WA; and Hannah M. Fisher and Francis J. Keefe, Duke University, Durham, NC
| | - M Elena Mendoza
- Karen L. Syrjala and Jean C. Yi, Fred Hutchinson Cancer Research Center; Karen L. Syrjala, Mark P. Jensen, and M. Elena Mendoza, University of Washington, Seattle, WA; and Hannah M. Fisher and Francis J. Keefe, Duke University, Durham, NC
| | - Jean C Yi
- Karen L. Syrjala and Jean C. Yi, Fred Hutchinson Cancer Research Center; Karen L. Syrjala, Mark P. Jensen, and M. Elena Mendoza, University of Washington, Seattle, WA; and Hannah M. Fisher and Francis J. Keefe, Duke University, Durham, NC
| | - Hannah M Fisher
- Karen L. Syrjala and Jean C. Yi, Fred Hutchinson Cancer Research Center; Karen L. Syrjala, Mark P. Jensen, and M. Elena Mendoza, University of Washington, Seattle, WA; and Hannah M. Fisher and Francis J. Keefe, Duke University, Durham, NC
| | - Francis J Keefe
- Karen L. Syrjala and Jean C. Yi, Fred Hutchinson Cancer Research Center; Karen L. Syrjala, Mark P. Jensen, and M. Elena Mendoza, University of Washington, Seattle, WA; and Hannah M. Fisher and Francis J. Keefe, Duke University, Durham, NC
| |
Collapse
|
33
|
Butow PN, Price MA, Bell ML, Webb PM, deFazio A, Friedlander M. Caring for women with ovarian cancer in the last year of life: A longitudinal study of caregiver quality of life, distress and unmet needs. Gynecol Oncol 2014; 132:690-7. [DOI: 10.1016/j.ygyno.2014.01.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 12/21/2013] [Accepted: 01/05/2014] [Indexed: 11/30/2022]
|
34
|
Srisuttayasathien M, Khemapech N. Quality of Life in Ovarian Cancer Patients Choosing to Receive Salvage Chemotherapy or Palliative Treatment. Asian Pac J Cancer Prev 2013; 14:7669-74. [DOI: 10.7314/apjcp.2013.14.12.7669] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
35
|
Hernandez SL, Sheyner I, Stover KT, Stewart JT. Dronabinol Treatment of Refractory Nausea and Vomiting Related to Peritoneal Carcinomatosis. Am J Hosp Palliat Care 2013; 32:5-7. [DOI: 10.1177/1049909113504240] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nausea and vomiting are common and often highly distressing symptoms in advanced cancer and in hospice and palliative medicine practice. Nausea and vomiting generally respond well to correction of the underlying etiology (when possible) and appropriate selection of antiemetic medication, but up to 7% of patients will have refractory symptoms. Dronabinol is extensively studied for chemotherapy-related nausea and vomiting, but there are only a few case reports of its use in nausea and vomiting unrelated to chemotherapy. We report a patient with end-stage ovarian cancer with peritoneal carcinomatosis and refractory nausea and vomiting who responded dramatically to addition of dronabinol. Dronabinol is usually well tolerated and may have several novel mechanisms of antiemetic action; further study of its scope of efficacy is warranted.
Collapse
Affiliation(s)
| | - Inna Sheyner
- University of South Florida College of Medicine, Tampa, FL, USA
- Hospice and Palliative Care Unit, James A. Haley VA Hospital, Tampa, FL, USA
| | - Karen T. Stover
- Hospice and Palliative Care Unit, James A. Haley VA Hospital, Tampa, FL, USA
| | - Jonathan T. Stewart
- University of South Florida College of Medicine, Tampa, FL, USA
- Hospice and Palliative Care Unit, James A. Haley VA Hospital, Tampa, FL, USA
| |
Collapse
|